title: Young women's constructions of the HPV vaccine: a cross-cultural, qualitative study in Scotland, Spain, Serbia and Bulgaria.
abstract: BACKGROUND
  Following international trends, the HPV (human papilloma virus) vaccine was introduced in Europe for protection against infection from common strands of the HPV virus which can lead to cervical cancer. Young women aged 18-26 years are at greatest risk of infection by the HPV virus yet have been neglected in research, policy, and practice.
  
  
  OBJECTIVE
  To explore young women's constructions of the HPV vaccine in four European countries with different implementation policies ranging from national school-based programmes, regarded as the gold standard, to regional on-demand and private provision.
  
  
  METHODS
  Qualitative methods comprising 11 focus group discussions with 54 young women aged 18-26, in Scotland (n = 10), Spain (n = 25), Serbia (n = 9) and Bulgaria (n = 10). A discursive analysis was conducted, following an initial thematic analysis.
  
  
  RESULTS
  Two competing discursive constructions were considered: the 'responsible young woman' discourse was constructed as someone with individual rights to health, choice and discretion along with responsibilities to protect health and make rational decisions. In 'the HPV vaccine: a discourse of exclusion', access to the vaccine, wider health promotion and knowledge was controlled by others which had the potential to undermine the young woman's health. We consider how young women managed this tension through recourse to being health vigilant.
  
  
  CONCLUSIONS
  Qualitative, cross-cultural research highlighted common concerns amongst young European women towards being responsible citizens in the face of their health and highlighted socio-cultural constraints to knowledge and resources. We highlight cross-cultural implications particularly between Western and Eastern European contexts.
authors.affiliation: Edinburgh Napier University, Edinburgh, UK, c.graybrunton@napier.ac.uk.
authors.forename: Carol
authors.initials: C
authors.lastname: Gray Brunton
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Farver
authors.forename: Moritz
authors.initials: M
authors.lastname: Jäger
authors.forename: Anita
authors.initials: A
authors.lastname: Lenneis
authors.forename: Kadi
authors.initials: K
authors.lastname: Parve
authors.forename: Dina
authors.initials: D
authors.lastname: Patarcic
authors.forename: Dafina
authors.initials: D
authors.lastname: Petrova
authors.forename: Rhona
authors.initials: R
authors.lastname: Hogg
authors.forename: Catriona
authors.initials: C
authors.lastname: Kennedy
authors.forename: Rocio
authors.initials: R
authors.lastname: Garcia-Retamero
authors.forename: Irina
authors.initials: I
authors.lastname: Todorova
mesh_terms: D000293:Adolescent; D000328:Adult; D002031:Bulgaria; D003431:Cross-Cultural Comparison; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D036301:Qualitative Research; D012606:Scotland; D055771:Serbia; D013030:Spain; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D016387:Women's Health; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines